Active NPI
Adam Douglas Deluca, LMT
- Massage Therapist
- Coeur D Alene, ID
National Provider Identifier
1356099733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAS-3813
- Practice address
- 1104 N 4TH St Unit B
Coeur D Alene, ID 83814-3217 - Phone
- (208) 292-4873
- NPI assigned
- Mar 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAS-3813 | ID | Primary |
Addresses
Primary practice location
1104 N 4TH St Unit B
Coeur D Alene, ID 83814-3217
Mailing address
1104 N 4TH St Unit B
Coeur D Alene, ID 83814-3217
Phone (208) 292-4873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MAS-3813 | ID | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Logan C Martin PC | Current | Accepting new patients |
Locations
1104 N 4th St
#B
Coeur D Alene, ID 83814
Phone (208) 292-4873
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Coeur D Alene, ID
- NPI 1477811750
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1356099733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 N 4TH ST UNIT B",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838143217",
"telephone_number": "208-292-4873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 N 4TH ST UNIT B",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838143217",
"telephone_number": "208-292-4873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELUCA",
"first_name": "ADAM",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-14",
"last_updated": "2022-03-14",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ID",
"license": "MAS-3813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.